﻿<div id="editModal" tabindex="-1" class="modal fade in" aria-hidden="true">
    <div class="modal-dialog">
        <div class="box box-info">
            <div class="box-header with-border">
                <h5 class="box-title" id="Title"></h5>
                <button class="close" aria-label="Close" type="button" data-dismiss="modal">
                    <span aria-hidden="true">×</span>
                </button>
            </div>
            <form class="form-horizontal">
                <input type="hidden" id="Id" />
                <input type="hidden" id="CreatedBy" />
                <input type="hidden" id="CreatedOn" />  

                <div class="box-body">
                    <div class="form-group">
                        <label class="col-sm-2 control-label" for="">伤者姓名</label>
                        <div class="col-sm-10">
                            <input class="form-control" id="InjureName" type="text" placeholder="被鉴定人姓名(必填)">
                        </div>
                    </div>
                    <div class="form-group">
                        <label class="col-sm-2 control-label" for="inputPassword3">身份证号</label>
                        <div class="col-sm-10">
                            <input class="form-control" id="IDNumber" type="text" placeholder="被鉴定人身份证号(必填)">
                        </div>
                    </div>
                    <div class="form-group">
                        <label class="col-sm-2 control-label" for="inputPassword3">联系电话</label>
                        <div class="col-sm-10">
                            <input class="form-control" id="InjureTel" type="number" placeholder="联系电话">
                        </div>
                    </div>
                    <div class="form-group">
                        <label class="col-sm-2 control-label" for="inputPassword3">鉴定结果</label>
                        <div class="col-sm-10">
                            <select id="InjuryResult" class="form-control" style="padding:0px">
                                <option value="未鉴定">未鉴定</option>
                                <option value="轻微伤">轻微伤</option>
                                <option value="轻伤二级">轻伤二级</option>
                                <option value="轻伤一级">轻伤一级</option>
                                <option value="重伤二级">重伤二级</option>
                                <option value="重伤一级">重伤一级</option>
                            </select>       
                        </div>
                    </div>
                    <div class="form-group">
                        <label class="col-sm-2 control-label" for="inputPassword3">鉴定法医</label>
                        <div class="col-sm-10">
                            <input class="form-control" id="Appraiser" type="text" placeholder="鉴定法医">
                        </div>
                    </div>
                    
                </div>
                <div class="box-footer">
                    <div class="pull-right box-tools">
                        <button id="btnSave" class="btn btn-primary" type="button">保存</button>
                        <button class="btn btn-default" type="button" data-dismiss="modal">取消</button>
                    </div>
                </div>
            </form>
        </div>
    </div>
</div>